“Breaking Gridlock: The determinants of health policy change in Congress”

A nice new article in JHPPL deserves a look.

I am on the masthead of the Journal of Health Politics, Policy, and Law. Beginning with the next issue, this journal will be edited by my hallway colleague Colleen Grogan here at the University of Chicago School of Social Service Administration. I edit a new “Point-Counterpoint feature,” about which more in due course.

The most interesting aspect of this paper is the large effort they have undertaken to code all of the 119,040 bills introduced into the U.S. House of Representatives from 1973-2002 by type of bill and then further whether the bill was substantively important or more symbolic. The paper argues that many explanations of past health policy legislative failures or successes have relied upon idiosyncratic â€˜one offâ€™ explanations that do not take account of the long run of observational data that are available on this question. For example, after the demise of the Clinton Plan in the early 1990s, some offered as an explanation the fact that the proposal was developed primarily in the executive branch and then moved into Congress as the key explanation for its failure. Similarly, as the ACA hung in the balance in early 2010 and seemed like it would not pass, some were saying that President Obama had made a mistake by letting the proposal be first developed in the Congress and therefore had not put his stamp on the bill. Opposite conclusions, using only 2 examples. Looking at a longer run of empirical data provides better information.

That’s a lot of coding, which produces unaccustomed insights.

Although I am not a political scientist, I’ve just joined the American Political Science Association because I’ve learned a lot from political scientists, on the web and off, during the health reform fight. I’ve attended APSA’s main meeting twice now. Much of it is really interesting and accessible to anyone. The nontechnical political science journal PS (along with its somewhat similarly-intended economics peer) Journal of Economic Perspectives is also worth a look.

These journals fill a real need to step out of the narrow subdisciplinary trenches many of us have dug. These trenches are often useful and necessary to make scholarly progress, but they bring obvious costs. I believe that serious policy journalist should be reading these journals to get a broader view, too.

After they’ve read Craig and Alan’s piece, of course.

Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect, tnr.com, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.
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